Abteilung Angiologie, Herz-Zentrum Bad Krozingen, Germany.
Catheter Cardiovasc Interv. 2009 Nov 15;74(6):934-8. doi: 10.1002/ccd.22130.
To report our experience with a catheter system (The Outback catheter) designed to allow fluoroscopically controlled re-entry after subintimal guide wire passage during recanalization of chronically occluded femoro-popliteal arteries.
Between March 2007 and August 2008, 65 legs in 61 patients (60% male, mean age 73 (49-98 years) with chronic occlusion of the SFA and proximal popliteal artery were treated. Clinical presentation was severe intermittent claudication (Rutherford category 3, 59%), rest pain (Rutherford category 4, 16%), and minor ulcerations (Rutherford category 5, 25%). In all cases, the true lumen could not be entered by using standard antegrade catheter and guide wire techniques.
Median lesion length was 200 +/- 102 mm. Recanalization of the arterial occlusion was successful in 57 of 65 treated lesions (88%). One patient died of myocardial infarction after delayed femoral bleeding possibly due to extensive recanalization attempts. There were no further procedure-related complications.
Use of the Outback re-entry catheter system is a valuable option for interventional therapy of chronically occluded femoro-popliteal arteries following failed standard antegrade recanalization attempt.
报告我们使用一种导管系统（Outback 导管）的经验，该系统旨在允许在慢性闭塞的股腘动脉再通过程中导丝穿过内膜下后，进行荧光透视控制下的重新进入。
在 2007 年 3 月至 2008 年 8 月期间，我们对 61 例患者的 65 条腿（60%为男性，平均年龄 73 岁（49-98 岁））进行了治疗，这些患者均患有股浅动脉和近段腘动脉的慢性闭塞。临床表现为严重间歇性跛行（Rutherford 分类 3，59%）、静息痛（Rutherford 分类 4，16%）和小溃疡（Rutherford 分类 5，25%）。在所有病例中，均不能使用标准的顺行导管和导丝技术进入真腔。
中位病变长度为 200±102mm。65 条治疗病变中有 57 条（88%）成功再通。1 例患者因广泛再通尝试后股部出血而死于心肌梗死，可能与广泛再通尝试有关。无进一步与手术相关的并发症。
在标准顺行再通尝试失败后，使用 Outback 再进入导管系统是治疗慢性闭塞的股腘动脉的一种有价值的选择。
